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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
15 1G:j 6
w 00'0 hx:. K """'A I\...
LEGAL DESCRIPTION (office use only)
Date Rec' d\
I_/I--O~
I. White File I PERMIT NO I
2 Pink City . 02 _ () a/l ~
] Yellow Applicant . LV 0 .
LOT2) BLOCK J ADDITION TJ.l.E Lv I LD..I 2
OWNER
(Name) 'J APA
(Address) / .53 6.s.
BUILDER
(Name)
(Contact Name)
~~eJ T,.u L
V}.. \k7
;SCI:}12.0EDE12-
.
12-G t.... j;;.
Iv A-pA- VA- \ \~7
~'MeJ
~ ~ c&,(Z-:-
~ c.J.,;I..,L ~
A. \N"~l~
A.JJ I ,J.to ~
PID 'S~?-3- O?-I-O
ZONING (office use)
PkO
(Phone) CJS2-226-'IS06
n to J- L.~k'C.
f..J 5.537'-
\"-
02~?
(Phone) Ci'sz-zZo- lJ800
(Phone) i:$2-Z2~ - '-I So.
or -[;1
(Address) 153~ ..$CJJ.!Z.OEOIC/Z-. CJfu:.ur -;::;".1'01' ~
m Iu .:S S 37'1-
TYPE OF WORK
ORe-Siding
o Misc.
~N ew Construction
o Lower Level Finish
ODeck
o Fireplace
PROJECT COST IV ALUE (excluding land) $
OPorch
ORe-Roofing
OUtility Connection
OAddition
OAlteration
I hereby certify that I have furnished information on this application which is to the best of my knowledge true and correct. I also certify that I am the owner or
authorized agent for the above-mentioned property and that all construction will conform to all existing state and local laws and will proceed in accordance with
submitted plans. I am aware that the building official can revoke this permit for just cause. Furthermore, I hereby agree that the city official or a designee may
enter upon the property to perform eeded inspections.
X N Z63Z1,/) 7-11'0'-
Permit Valuation
Permit Fee
Plan Check Fee
State Surcharge
Penalty
Plumbing Permit Fee
Mechanical Permit Fee
Sewer & Water Permit Fee
Gas Fireplace Permit Fee
ur Building Permit When Approved
7-{ '(-07
Date
$
$
$
$
$
$
$ I
$
/0 z" $ C/..
~~3g ~ dJ-i ~~ceiEt No. #~706
Contractor's License No.
Park Support Fee
#
Date
.cO
.00
.OlJ
00 .00
.00
.00
SAC
#
is to certify that the request in the above application and accompanying documents is in accordance with the City Zoning Ordinance and may proceed as requested. This documf
'iryed by th~ City Planner constitutes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy, a Certificate of Occupancy mus.
~~.c .cq~ '7 /t.~( /0'7: s;.:c.c -4.,~,*C~(~ (' "'''C~~~,
Planning Director Date. eci I Conditions, If oftty
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Avenue Prior Lake, MN 55372
Water Meter
Size5/8.1".
Pressure Reducer
City SAC and WAC
#
Water Tower Fee
#
Builder's Deposit
Other
TOTAL DUE
Paid
Date
/
White - Building
Canary - ~ngineering
Pink - Planning
The' C'fnlrr of Iht I..kf' ('oun.,.,.'
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT 17 /ijooJ () IJ lb.d;t Uf'Ylnt2d ~
APPLICATION RECEIVED -;- / (- ~ C)
The Building, Engineering, and Planning Departments have reviewed the building permit
~'" application for construction activity which is proposed at:
15/9/'='- !/)o(d~/c Ty-
Accepted
'X
"
Accepted With Corrections
)
Denied
Date: 7 (-1..(g 10 z..
I I
See Reverse Side for Additionallnformationl
L
Reviewed By:
Comments:
O~\lt::.LJA<{ c-~Lof('~ VY\lJ~T ~T 0<GE.~,L\ \D ~I 0
- GoJ-JV( cr ~l...L Su{{fAQ lA,AT~,<" AWN? FRoW\ f:/ou~G. '
-.: 0 f(1:J..Jf-O SWJ\Lf. S ~!..G<.r~f:..O AL...oI0G 10~-rM AIJIj
~Oun1 'P RoP~\<( h1J.Jf<;
-- ~()A..& (Cox VV\ J s-( H A 0f. A - I GAS-r::r..o G, Ass E:.-r"\ (\ L Y
See Attachments: 1) Grading Plan, 2) Erosion Control Measures
3) Erosion Control Plan
"The issuance or granting of a permit or approval of plans, specifications and
computations shall not be construed to be a permit for, or an approval of, any violation of
any of the provisions of this code or of any other ordinance of the jurisdiction. Permits
presuming to give authority to violate or cancel the provisions of this code or other
ordinances of the jurisdiction shall not be valid."
\
Tht" {'("nfer of tht' Lab Countr)'
White - Building
Canary - Engineering
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT /I t3j0tu tJ d~ ~ ~
APPLICATION RECEIVED -;- 11- ~
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
LI)()~c TV-
)(
/ 5/9 ~-
Accepted
Accepted With Corrections
Denied q m --,k-
Reviewed BY&~"-'\
~n;:;S:~Qtk~ h~~
Date: 7--/9.....~
"The issuance or granting of a permit or approval of plans, specifications and
computations shall not be construed to be a permit for, or an approval of, any violation of
any of the provisions of this code or of any other ordinance of the jurisdiction. Permits
presuming to give authority to violate or cancel the provisions of this code or other
ordinances of the jurisdiction shall not be valid."
f:
White - Building
Canary - Engineering
Pink - Planning
The Cenln of the L.kt Counlry
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
_.J
APPLICATION RECEIVED
I' / /
-~"'.
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
'.. (
.I Y"
,
/,
\.....-
Accepted
~
Accepted With Corrections
Denied
Reviewed By: ~"I t~~~~
cO'Aents:
L t~')~\j(~
I'
~ P ;V\_C-\/~&V ~_
~.~
Date:
7/2-:5 102----
~LJ ,'~~~ $)' LvJ.l
U/Fl ~~~)
"The issuance or granting of a permit or approval of plans, specifications and
computations shall not be construed to be a permit for, or an approval of, any violation of
any of the provisions of this code or of any other ordinance of the jurisdiction. Permits
presuming to give authority to violate or cancel the provisions of this code or other
ordinances of the jurisdiction shall not be valid."
FROM :ALLIED EXCAVATING FAX NO. :952-895-9394
U~.lll(i.l2 !liE l)g~.~ FAX 6HH74U5 <;:IT\' Or fRI0~ LAKE
Sep. 26 2002 10:13AM P1
(lj 00 1
Da" Rec'cS
CITY OF PlUOR LAKE
SEWER AND WATER PERMIT
!
~~.Jr2B_1It' priar MIQ.:s\I!i~ btelD~
. ADDRESS i
I I
jSJ<1(g ~o~ciu~~ l(c:.\ \
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r" ....- [1
, LEGAL OESClUi'l1ON t..CIi<< - cnU))
! :
l LOT BLOCK ~ A.Dt)mo~ ____
I OWNER,.-...: -
I f.'IlIm~) ,:\c:.~ a~m 'a c..h tA-
I (A4dJes,' ~
. .!~)
r:-:: ....j....
I ~~t'~\ \l~-L
i (AdCJess) ~D\ i W
I (Ad*-.)
\ (ContloCt Pc=non) :
l APFLICANT SIGN"';
t :;::. ~_ ~RM1T NO. 00 -6'1oB J
Pl. I toNtN'G(P*--)~.l
Y\'~'1 LeI&- .J-'
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(!'hone) ''1 ~ J. - ~'i ~ - ~ ~~(J -- I
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___~APPLIC~ PLEASE COMP~ET~ BELOW
~l'ze Df w.teT servlc.e ~ inche,.
Uaca1ion of GY QOupliqs nom StlUC:~ feet.
. 1ype of sewer pipe, 0 ABC ~ 0 Cast Iron
~stimlted length of sewer line ~
gleaft out (ifr~'.<:ec!) located a.t _ . feet from IU'UCNrt.
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FEE SCHEDVLJ:
Re;ldentlal sewCf lln~ .....1\1\0 eOM"tloll 535.50 lnd\l.c-ial. COI!t '1" Multi.flmlly 1'Yi of Jo" COIl wiU! 8 S19,,5C miftil!M1'l
Scw'l'l;or\!\ectionQnly ! S17.50 WawC:OIln':UonOllly 117.50
'sdmaeed CCSt $ 8\lildin~ P..mit tj... -." . . . D Z, ~ (fj 0 f>
! SEWEk AND W A TE.R PE.RMIT nf: $
STATE suaCHAROB S
T01'AL PlItMlT FEI $ = PAID WITH
BlJll,DING PERMIT
~,!,It.~ \.'9C Olll:!') i _.~_
=:~~:... -r-"- ..........- -- .........1
L- Bull.l", omlli.. ~ 0.,. J
I )4 hOllr IIOriU for IllllI',IClioN (95:) 44'....$0. fU ~) ""42.s
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r~l6 2IDl__
CITY OF PRIOR LAKE
HEATING/AIR CONDITIONING/FlREPLACE PERMIT
Date Rec'd
~. ~;e~n ~::y I PERMIT NO. .;;:> ..t) /),.{;;;
3. Yellow Applicant c... . i "- t,,)
ADDRESS ZONING (office use)
15196 WOODDUCK TRAIL
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
OWNER
(Name)
NAP A VALLEY HOMES
(Phone)
(Address)
APPLICANT
(Name) ALLIED FIRESIDE DBA FIRESIDE CORNER
(Phone)
651-633-2561
(Address)
2700 NORTH F AIRVIEW AVENUE
(Address)
ROSEVILLE
(City)
55113_
(Zip Code)
(Contact Person)
BRENDA HUSTON
(Phone) _651-633-2561
APPLICANT SIGNATURE
BRENDA HUSTON
DATE
10/18/02
xD NEW CONSTRUCTION o REPLACEMENT o ALTERATIONS
FURNACE MAKE AND MODEL FUEL
FLUE SIZE RETURN OPENINGS INPUT OUTPUT
TYPE OF SYSTEM HEATING OR POWER PLANT
OWarm Air Plants o Steam PLEASE NOTE:
OGravity o Hot Water Air Conditioner Units
o Mechanical o Radiation Cannot Encroach into
OAir Conditioning o Special Devices Required Side Yard
OVent. System o Other Devices Setbacks
FIREPLACE MAKE AND MODEL HEATN GLO 6000TR-OAK
APPLICANT PLEASE COMPLETE BELOW
Residential, Heating & AlC (New Construction)
Residential, Heating Only (New Construction)
FEE SCHEDULE
I % of job cost Residential, Gas Fireplace
$39.50 minimum
$99.50 Residential, Additions & Alterations
$64.50 Residential, AC Only
$39.50
Industrial, Commercial & Multi-Family
$39.50
$39.50
Estimated Cost $
REA TING PERMIT FEE
STATE SURCHARGE
TOT AL PERMIT FEE
Building Permit #
$
$
$
.50
,.--,
(Office Use Only)
This Application Becomes Your Building Permit When Approved
Paid
Receipt No.
Date
Datttr 2 5 2002
By
BuiIdinl! Official
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
CITY OF PRIOR LAKE
HEATING/AIR CONDITIONINGfFIREPLACE PE&mT
Date Rec'd
r(Pica~e ~'print and sigr. ill bottom)
I ADDRESS
I /)f 9~ OJO.Od d ~k 711.141 J
~'~;:n ~:~7 I PER1\llT NO. /)..., () 6V I
). 'Yt:HC1r ~.p,ho.r.1 L (7' ~ () 1
I ZOl> Th'G (ore" ",,'
I LEGAL DESCRIPTION (offic~ u~e only)
I LOT BLOCK ADDITION
PID
IOWNER
! (Name)(} 4 p <4
UAt ky
I./.c;Me~
(Phone)
(Address)
I APPLICA.l'JTA- ~- ~
I O'~ame) , 11 06 {Zf d " (/( '/"A1. (
\ (Address) ~O 3 {}:,1-t(f.-,/ I '7' h n 2
J - (A.d~C:$s)
I (Contact Pmon) j)"vt ;1/1,12""
~LlCANT SIGNATURE
(phone) '1 ~ .). - g'? (.1.-:: 7 9:5 7'
/dUl1W5iJC! LL (VI/lJ S-~'33 7
(City) (Zip Code)
(Phone) S J4.r-v(..
DATE /J..-t9-())....
I
I
-.I
_ APPLICANT PLEASE COMPLETE BELOW
I ~EW CONSTRUCTION 0 REPLACEMENT 0 AL TERA TIONS
: FuRNACE MAKE AND MODEL Drzy/A-fll. 35"OMt.1.JO~~jOO FUEL 1114- ~1A0\41
I FLUE SIZE __f!l!L RETURN OPENINGS B INPUT /OrJ/()TJO OUTPUT 9),ODO
TYPE OF SYSTEM HEATING OR PO\VER PLANT
PLEASE NOTE:
Air Conditioner Units
Cannot Encroach into
Required Side Yard
Setbacks
OWarm At; Plar,ls
OGravity
o Mechanical
~u Conditioning
~ent System
o Steam
o Hot Water
o Radiation
o Special Devices
o Other Devices _
I
I FIREPLACE MAKE AND MODEL
Industrial. Com!ncrcbJ & Multi-Family
FEE SCHEDULE
I % of job cost Residential. Gas Fireptace
$39,50 mmimum
$9950
$64 .5 0
S39.50
Residential, HC:Jling & ,A,/C (New Construction)
Residentiul. Hc~:ng Only (New Construction)
Residential, AddItions & Alterations
Residential, AC Only
S39.50
$39,50
estimated Cost ~
Building pennit 11
HEA TING PER..\.1IT FEE
ST A TE SURCHARGE
TOT AL PERMIT FEE
$
$
$
.50
"
(Office l)',e Only)
This Application Becom(:<j Your Building hrm!t When Approved
Bulldinr, om'lkl
L-_..____
Uw
I
__J
I Paid
l__DaOEC t.. J- 20~)
I Recel"pt No, I
I '
i By ~__ ]
, I L..._...' . i . I' ,/"\....... ..,.., ,...l~"n I' ,/"\..>,..........
1d IJdge: n e00e 61 ':Jaa 5[5Lt'58cS6 : U~ ><d.:l
J1d uOSJapub WOd.:l
Oct 16 02 09:50a Mik@ Schiltz
VII( l:>/l!~ TItU 14:.u "o'A.\ 61l4t1Hl4:J
651-681-8306
f'. 1
~IVUL
Llll Ut t'KIUI< LAI\t.
I
Date Rec:' d
CITY OF PRIOR LAKE PLUMBING PERMIT
I, 1M- PlI.
1 Oold 1:.1
,. YIC'1'-_ ^...~
I PERMIT NO. ,;( -- qrft
I I ZONlNGI~tt"~~j
(PI.,;UC: fYIIC or NCllld,iaJ at botwllll
IADDIll!SS
/5/ C)~
G-J()O~
Dvc.L-<
T ra..
I LEGAL DESCalPTION ,..... - ""',
LOT BLOCK ADDITION
PIn
OWNER
(Name) ;V r'f pa._
(Address)
U-\\..o,\
l-\ .,.. ,~ D ;
(Phon~) 9.s 2. - ~ ~ <.
- 4 8Q <0
I
APPUCANT
(Name)
(Contact Person)
(Address)
f1r- -) V'-.D
(phone)
Hessian "umbing Services, Inc.
P.o. BUA ~ 172 (C" )
Eagan, MN 55122-0172 Ky
(~ .s J- <... 'is ) - & ~ .s <..
(Address)
(Zip Code)
APPLICANT SIGNA TUR.~
(Phone)
(..., So )- lo '8- 1- &- 2...5 <-
DATE /u - / t.. - d ~
APPLICANT PLEASE COMPLETE BELOW
Quantity Type of Fisture Quaatity Type or Fixture
2- Bath Tub with or without shower ----.--..-- .3 Rough-ins
J Dishwasher Water Heater
,- Floor Drain Water Softner
.S Lavatory (Bathroom Sink) Stand Pipe (Washing Machine)
I Laundry Tray (1 or 2 compartment sink Sewage Ejector
i I Shower Stall Backflow Assembly
I Smks -,--_..._- Bllckflow Assembly Test
Bar Sink I Lawn Sprinkler
~ Warr:r Closet (Toilet) Other
FEE SCHEDULE
Industrial, Commcn;illl &. Multi-rM\ily 1% orjob c;olt wiet. . 539.50 minimum
/lcsidc;ntial. New One &. Two-FDmily 599.50
Rl:Sidencill. Additions A Alteralions 1]9. SO
Estimated Cost S
Building Permit tI
PLUMBING PERMIT fEE S
STATE SURCHARGE S
TOTAL PERMIT FEE S
.so
r::, r:J ~~ q"rq
r""~ ~ 1 "''''..~ ~,~ l~' 'J
..... .~." . -:.. ....... ~ , '~..J ~i
(Olfirr Uac Only)
I~~~
Building Oftiolll
Daft
t;i
D~ _ 25.
This Application Become VOllr BUlldiDg Permit When Apprvvcd
24 bour .Dlia: ror .n iRlpCCIiD.. (tsz) "7.tlSO, ru (tSZ) 447..Z45
16100 YIIe Cl'ftl< Aft.. S-L. Prior Lake, MN 55371-1714
PRIOR LAKE
INSPECTION RECORD
DEPARTMENT OF
BUILDING AND INSPECTION
SITE ADDRESS J51j(o lJ~ ()\Jck \ro..\ \
- ,.
NATURE OF WORK ""\.(2.... ')
USE OF BUILDING ~f1)
PERMIT NO, -0 ~ DATE ISSUED -2:1"1-0<_
CONTRACTOR 0. Q..l -- PHONE~ -1~ -tf&Jf..t
NOTE: THIS IS NOT A PERMI FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
INSPECTOR DATE
! FOOTING I~, t 1//f'/4 z..
I FOUNDATION (Prior to Backfill) i We /52tf::; ..'
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
:
SEWER I WATER I SEPTIC tv L:!?
c.
FRAMING N,-;P / 0 ~~0
INSULATION ?B ,;t/-
ELECTRICAL
PLUMBING ~, ~~ ~/-/
HEATING (if required) ~..
,.
FIREPLACE . ,.
GAS LINE AIR TEST
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
I ~c,o L.~ I I
FINALS
GRADING (Prior to Sodding)
BUILDING .--, i-cs-'.O"3
ELECTRICAL
PLUMBING
HEATING
DO NOT
This card must be posted near an electrical se.rv.ice cabinet prior to rough-in inspections
and maintained until all inspections have been approved. On buildings and additions
where no service cabinet is available, card shall be placed near main entrance.
-.iJ
OCCUpy UNTIL ABOVE HAS BEEN SIGNED
NOTICE
FOR ALL INSPECTIONS (952) 447-9850